What Are Omega 3 Fatty Acids?
Omega-3 fatty acids are essential fatty acids (EFAs). EFAs are long-chain polyunsaturated fatty acids (PUFAs) derived from linolenic, linoleic and oleic acids. They are called essential as EFAs are necessary for many functions in the body and are required for maintenance of optimal health. As they cannot be synthesized in the body, they must be obtained through diet or supplementation. The other essential fatty acids are omega-6 fatty acids. These polyunsaturated fatty acids (PUFAs) remain in a liquid form even in cold weather, unlike saturated oils which solidify. Monounsaturated fats, found in olive oil, are liquid at room temperature, but harden when refrigerated.
Deficiency of EFAs and imbalance of omega-3 and omega-6 fatty acids is associated with serious health conditions, such as heart attacks, obesity, diabetes, cancer, asthma, schizophrenia, depression, stroke, arthritis and Alzheimer’s disease, among several others.
Types of Omega-3 Fatty Acids
There are three main types of omega-3 fatty acids that are important to human nutrition and are utilized by the body to perform different functions.
- Eicosapentaenoic acid (EPA)
- Docosahexaenoic acid (DHA)
- Alpha-linolenic acid (ALA)
Dietary Sources of Omega-3 Fatty Acids
The rich dietary sources of omega-3 fatty acids are:
- Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA): oily cold-water fish (mackerel, sardine, tuna, anchovy and salmon, etc.)
- Alpha-linolenic acid (ALA): vegetable oils like flaxseed or linseed oil, rapeseed or canola oil, peanut oil, olive oil, soya oil, walnut oil, green leafy vegetables, fenugreek seeds, kidney beans, dry fruit seeds and oils.
Metabolism of Omega-3 Fatty Acids
Enzymes in the human body change the parent omega-3 fatty acid, ALA to form EPA and DHA. But this conversion is slow and inefficient as only a small portion of ingested ALA is converted into active EPA or DHA. During early life, the body has limited capacity to convert ALA to DHA. Therefore, during fetal life, infancy and early childhood, DHA should be taken from very early age.
Dietary fats have been traditionally looked upon as â€˜badâ€™ because the fat, in general, is implicated in heart disease, stroke, obesity or diabetes. New research published in 2008 has indicated that India will bear 60% of the worldâ€™s heart disease burden in the next two years. Also, the prevalence of diabetes in India is 35 million, the highest number in any given country and that has been projected to rise to 57 million by the year 2025 making up one-sixth of the world total. Hence, this association between dietary fat and heart disease has formed the basis of reducing risk. But not all fat is bad.
Recommendations from several organizations like the American Heart Association (AHA) have stressed on â€˜taking the right fat since the type of fat is more important than total fatâ€™. Omega-3 fatty acids, which are a type of polyunsaturated fatty acid, have been studied as a potential therapy for a variety of disease conditions besides heart disease.
Interest in omega-3 fatty acids first began in the 1970s when the beneficial health effects of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were described first in the Greenland Eskimos who consumed a high seafood diet and had low rates of coronary heart disease, asthma and diabetes mellitus. Since then, there has been significant research on omega-3 fatty acids that has reversed the traditional thinking about fats.
In addition to their evident role in the prevention of heart disease, the importance of omega-3 fatty acids in a number of other disease conditions viz. rheumatoid arthritis, inflammatory bowel disease and asthma, among others have emerged. The clear evidence of their role, especially of DHA, in brain and retina that has obvious implications for maternal and infant nutrition.
There are three main types of omega-3 essential fatty acids, EPA, DHA and ALA. Flax seed oil vs fish oil is as simple as EPA and DHA vs ALA. The omega-3 fatty acids in fish oil are the EPA and DHA fatty acids and the omega-3 fatty acids in flax seed oil are the ALA fatty acids.
The human body can convert ALA into EPA and DHA, but the conversion process is slow. Plant-based omega-3 fatty acids (i.e. ALA), like flaxseed oil, are poorly converted to the biologically active omega-3 fatty acid EPA, and converts even less to DHA.
Hence, plant-based omega-3 fatty acids cannot replace fish oil based EPA+DHA. Foods containing n-3 PUFA (ALA), rather than marine omega-3 PUFAs, may be heart-healthy but cannot yet be considered a replacement for EPA and DHA. Consumption of either EPA or DHA alone is inadequate to provide all cardiovascular benefits. Heart Care Foundation of India (HCFI) recommends that consumption of both EPA and DHA is preferable. Fish oil supplements are made up of EPA and DHA. They are a more concentrated source of omega-3 fatty acids that have been studied for their clinical benefits.
In the comparison of flax seed oil vs fish oil, both have their benefits, but fish oil is considered superior.
Omega-3 vs Omega-6
Omega-6 fatty acids, also considered essential, are found in foods such as vegetable oils like Sunflower oil, Safflower oil, Sesame oil, Palmolein oil and Corn oil, grains, processed foods, meat, milk, eggs. They support skin health, lower cholesterol, and help make our blood “sticky” so it is able to clot.
Balance of Omega-6/Omega-3 Fatty Acids is Important for Health
The ratio between omega-6 and omega-3 fatty acids is important as the two fatty acids are metabolized by the same enzymes. An increase in the diet of one decrease metabolism of the other. The EFAs i.e. omega-3 and omega-6 fatty acids, should be in an optimal or best possible ratio in diet, which is important for normal growth and development and help fight many diseases including heart disease. The ideal ratio is 5-10:1 for optimal health benefits.
The imbalanced consumption of the two families of EFAs contributes to a range of diseases. Omega-3 fatty acids reduce inflammation (anti-inflammatory), whereas omega-6 fatty acids promote inflammation (pro-inflammatory). So, omega-6 fatty acids may counteract the potential benefits of omega-3 fatty acids on the heart. A ratio above 50 is harmful to health.
Compared with traditional diets, intake of PUFAs has clearly shifted toward higher amounts of omega-6 fatty acids. Most Western diets provide too many omega-6 EFAs and not enough omega-3 EFAs. The estimated ratio of omega-6: omega-3 fatty acids in the present Western diet is about 20:1. A high omega-6/omega-3 ratio, as is found in today’s Western diets, promotes the development of many diseases, including heart disease. Most Indians eat a diet of omega-6 and omega-3 fatty acids in a ratio of 30-70:1. This trend is now evident even in the rural Indian population due to changes in diets and lifestyle. Asian Indians have a low intake of MUFA, n-3 PUFA and fiber, and high intake of fats, saturated fats, carbohydrates and trans-fatty acids (mostly related to the widespread use of Vanaspati, a hydrogenated oil). This dietary profile predisposes Indians to an increased risk of chronic noncommunicable diseases including obesity, diabetes mellitus, coronary heart disease, hypertension and stroke and some types of cancer.
These nutrient imbalances are associated with diabetes and high lipid levels in the blood (dyslipidemia) and subclinical inflammation which underlie the higher tendency of Asian Indians to develop type 2 diabetes mellitus and early-onset atherosclerosis.
Dosage for fish oil supplements should be based on the amount of EPA and DHA in the product, not on the total amount of fish oil.
Supplements vary in the amounts and ratios of EPA and DHA. A common amount of omega-3 fatty acids in fish oil capsules is 0.18 grams (180 mg) of EPA and 0.12 grams (120 mg) of DHA.
Individuals taking more than 3 grams daily of omega-3 fatty acids from capsules should do so only under the supervision of a health care provider due to an increase risk of bleeding.
For healthy adults with no history of heart disease:
The American Heart Association (AHA) recommends eating fish at least 2 times per week.
For adults with coronary heart disease:
The American Heart Association (AHA) recommends an omega-3 fatty acid supplement (as fish oils), 1 gram daily of EPA and DHA. It may take 2 – 3 weeks for benefits of fish oil supplements to be seen.
For adults with high cholesterol levels:
The American Heart Association (AHA) recommends an omega-3 fatty acid supplement (as fish oils), 2 – 4 grams daily of EPA and DHA. It may take 2 – 3 weeks for benefits of fish oil supplements to be seen.
Possible Interactions with Omega 3
If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), without first talking to your health care provider.
Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopedigrel (Plavix). While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as in heart disease), they should only be taken together under the guidance and supervision of a health care provider.
Blood sugar lowering medications
Taking omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking blood sugar lowering medications, such as glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase or Diabeta), glucophage (Metformin), or insulin, as omega-3 fatty acid supplements may increase your need for the medication(s).
Taking omega-3 fatty acids during cyclosporine (Sandimmune) therapy may reduce toxic side effects, such as high blood pressure and kidney damage, associated with this medication in transplant patients.
Etretinate and topical steroids
The addition of omega-3 fatty acids (specifically EPA) to the drug therapy etretinate (Tegison) and topical corticosteroids may improve symptoms of psoriasis.
Following certain nutritional guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering medications known as “statins”, including atorvastatin (Liptor), lovastatin (Mevacor), and simvastatin (Zocor) to work more effectively.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin or Advil) and naproxen (Alleve or Naprosyn). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.
- Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications, including warfarin (Coumadin) or clopidogrel (Plavix), because excessive amounts of omega-3 fatty acids may lead to bleeding. In fact, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal condition in which an artery in the brain leaks or ruptures.
- Fish oil can cause flatulence, bloating, belching, and diarrhea. Time-release preparations may reduce these side effects, however
- People with either diabetes or schizophrenia may lack the ability to convert alpha-linolenic acid (ALA) to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the forms more readily used in the body. Therefore, people with these conditions should obtain their omega-3 fatty acids from dietary sources rich in EPA and DHA. Also, individuals with type 2 diabetes may experience increases in fasting blood sugar levels while taking fish oil supplements. If you have type 2 diabetes, only use fish oil supplements under the supervision of a health care provider.
- Although studies have found that regular consumption of fish (which includes the omega-3 fatty acids EPA and DHA) may reduce the risk of macular degeneration, a recent study including 2 large groups of men and women found that diets rich in ALA may substantially increase the risk of this disease. More research is needed in this area. Until this information becomes available, it is best for people with macular degeneration to obtain omega-3 fatty acids from sources of EPA and DHA, rather than ALA.
- Similar to macular degeneration, fish and fish oil may protect against prostate cancer, but ALA may be associated with increased risk of prostate cancer in men. More research in this area is needed.
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